Self-management education for rehabilitation inpatients suffering from inflammatory bowel disease: a cluster-randomized controlled trial

Abstract

Although inflammatory bowel disease (IBD) affects patients' psychological well-being, previous educational programs have failed to demonstrate effects on psychosocial outcomes and quality of life. Therefore, we developed a group-based psychoeducational program that combined provision of both medical information and psychological self-management skills, delivered in an interactive manner, and evaluated it in a large, cluster-randomized trial. We assigned 540 rehabilitation inpatients suffering from IBD (mean age 43 years, 66% female) to either the new intervention or a control group comprising the same overall intensity and the same medical information, but only general psychosocial information. The primary outcome was patient-reported IBD-related concerns. Secondary outcomes included disease knowledge, coping, self-management skills, fear of progression, anxiety, depression and quality of life. Assessments took place at baseline, end of rehabilitation and after 3 and 12 months.The psychoeducational self-management program did not prove superior to the control group regarding primary and secondary outcomes. However, positive changes over time occurred in both groups regarding most outcomes. The superior effectiveness of the newly developed psychoeducational program could not be demonstrated. Since the intervention and control groups may have been too similar, this trial may have been too conservative to produce between-group effects.

The Effectiveness of Actively Induced Medical Rehabilitation in Chronic Inflammatory Bowel Disease

“…In the MERCED study, the strategy of proactively approaching insured persons potentially in need of rehabilitation may have brought a patient group to MR which is not normally seen there. However, the fact that the patient population of the MERCED study is more similar in its characteristics to other samples recruited in rehabilitation clinics (31,32) than to IBD samples from outpatient care (33,34) supports the appropriateness of the approach (eTable 6). Only in the area of school education is there an obvious difference: The proportion of patients with lower school education (max.…”

Assessment of patients' understanding of inflammatory bowel diseases: Development and validation of a questionnaire

“…3 Patients' beliefs and knowledge regarding the disease may affect disease management, quality of life and disease-related psychological health. [4][5][6] Therapyrelated disinformation is associated with low adherence to treatment, 7,8 while understanding of disease course empowers patients, improves their satisfaction 9 and compliance with treatment, 5,[10][11][12] probably resulting in better therapeutic efficacy. 13 Furthermore, structured educational programs were associated with increased patient adherence to therapy.…”

The impact of an adaptation course on health-related quality of life and functional capacity of patients with inflammatory bowel disease

“…While many studies underline the importance of adaptation in IBD patients to maintain their working capacity and quality of life, little is known about how this is achieved [22]. Many educational programs developed for IBD patients have shown no or limited effect on patient psychosocial outcomes [11,12,23]. Disability in IBD is a highly underestimated problem and considerably fewer studies on this topic are available when compared to many other chronic diseases [24].…”